By Public Health Wales Observatory (2020)
Category: Healthy Settings
The Lancet Public Health Volume 5, ISSUE 9, e475-e483, September 01, 2020
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Background
Data for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk.
Methods
We did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. We used Cox proportional hazards modelling to estimate multivariate-adjusted hazard ratios (HRs) of our primary outcome, which was a positive COVID-19 test. The COVID Symptom Study app is registered with ClinicalTrials.gov, NCT04331509.
Findings
Among 2 035 395 community individuals and 99 795 front-line health-care workers, we recorded 5545 incident reports of a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37–3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors.
Interpretation
In the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers. Health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds. Additional follow-up of these observational findings is needed
by Public Health England (2020)
National monitoring tool that brings together metrics to assess the wider impacts of coronavirus (COVID-19) on health.
by Public Health England (2020)
During the COVID-19 response sexual and reproductive health services have adapted swiftly to ensure continued provision of essential services. This has included, for example, the scale up of online triaging and delivery, and prioritising face-to-face consultations for less well served groups, clinically complex cases and to address safeguarding concerns.
Public Health England is collating practice examples to capture how sexual and reproductive health services have adapted during the COVID-19 response with a particular focus on changes put in place to meet the needs of less well served populations. The practice examples below have been collected and published with no assumption or evidence of effectiveness at this stage. They are intended to briefly capture what has been done locally for the purpose of rapid knowledge translation. The practice examples were collected by PHE from local sexual and reproductive health providers and commissioners. PHE is collecting examples on an ongoing basis.
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The Lancet Public Health Volume 5, ISSUE 8, e452-e459, August 01, 2020
In countries with declining numbers of confirmed cases of COVID-19, lockdown measures are gradually being lifted. However, even if most physical distancing measures are continued, other public health measures will be needed to control the epidemic. Contact tracing via conventional methods or mobile app technology is central to control strategies during de-escalation of physical distancing. We aimed to identify key factors for a contact tracing strategy to be successful.
The Lancet Public Health Volume 5, ISSUE 7, e404-e413, July 01, 2020
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Background
One possible policy response to the burden of diet-related disease is food taxes and subsidies, but the net health gains of these approaches are uncertain because of substitution effects between foods. We estimated the health and cost impacts of various food taxes and subsidies in one high-income country, New Zealand.
Methods
In this modelling study, we compared the effects in New Zealand of a 20% fruit and vegetable subsidy, of saturated fat, sugar and salt taxes (each set at a level that increased the total food price by the same magnitude of decrease from the fruit and vegetable subsidy), and of an 8% so-called junk food tax (on non-essential, energy-dense food). We modelled the effect of price changes on food purchases, the consequent changes in fruit and vegetable and sugar-sweetened beverage purchasing, nutrient risk factors, and body-mass index, and how these changes affect health status and health expenditure. The pre-intervention intake for 340 food groups was taken from the New Zealand National Nutrition Survey and the post-intervention intake was estimated using price and expenditure elasticities. The resultant changes in dietary risk factors were then propagated through a proportional multistate lifetable (with 17 diet-related diseases) to estimate the changes in health-adjusted life years (HALYs) and health system expenditure over the 2011 New Zealand population’s remaining lifespan.
Findings
Health gains (expressed in HALYs per 1000 people) ranged from 127 (95% uncertainty interval 96–167; undiscounted) for the 8% junk food tax and 212 (102–297) for the fruit and vegetable subsidy, up to 361 (275–474) for the saturated fat tax, 375 (272–508) for the salt tax, and 581 (429–792) for the sugar tax. Health expenditure savings across the remaining lifespan per capita (at a 3% discount rate) ranged from US$492 (334–694) for the junk food tax to $2164 (1472–3122) for the sugar tax.
Interpretation
The large magnitude of the health gains and cost savings of these modelled taxes and subsidies suggests that their use warrants serious policy consideration.
The Lancet Public Health Volume 5, ISSUE 7, e395-e403, July 01, 2020
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Background
Retirement ages are rising in many countries to offset the challenges of population ageing, but people’s capacity to work for more years in their later working life (>50 years) is unclear. We aimed to estimate healthy working life expectancy in England.
Methods
This analysis included adults aged 50 years and older from six waves (2002–13) of the English Longitudinal Study of Ageing (ELSA), with linked mortality data. Healthy working life expectancy was defined as the average number of years expected to be spent healthy (no limiting long-standing illness) and in paid work (employment or self-employment) from age 50 years. Healthy working life expectancy was estimated for England overall and stratified by sex, educational attainment, deprivation level, occupation type, and region by use of interpolated Markov chain multi-state modelling.
Findings
There were 15 284 respondents (7025 men and 8259 women) with survey and mortality data for the study period. Healthy working life expectancy at age 50 years was on average 9·42 years (10·94 years [95% CI 10·65–11·23] for men and 8·25 years [7·92–8·58] for women) and life expectancy was 31·76 years (30·05 years for men and 33·49 years for women). The number of years expected to be spent unhealthy and in work from age 50 years was 1·84 years (95% CI 1·74–1·94) in England overall. Population subgroups with the longest healthy working life expectancy were the self-employed (11·76 years [95% CI 10·76–12·76]) or those with non-manual occupations (10·32 years [9·95–10·69]), those with a tertiary education (11·27 years [10·74–11·80]), those living in southern England (10·73 years [10·16–11·30] in the South East and 10·51 years [9·80–11·22] in the South West), and those living in the least deprived areas (10·53 years [10·06–10·99]).
Interpretation
Healthy working life expectancy at age 50 years in England is below the remaining years to State Pension age. Older workers of lower socioeconomic status and in particular regions in England might benefit from proactive approaches to improve health, workplace environments, and job opportunities to improve their healthy working life expectancy. Continued monitoring of healthy working life expectancy would provide further examination of the success of such approaches and that of policies to extend working lives.
By Health Information and Quality Authority (2020)
To inform the ongoing response to the COVID-19 pandemic, specifically, to inform the development of public health guidance to prevent the spread of COVID-19, we have created a database of COVID-19 public health guidance produced by international organisations.
This database is updated daily, and is primarily for the use of relevant stakeholders in the Health Protection Surveillance Centre, the National Public Health Emergency Team, the Department of Health, and Health Service Executive.
By The Centre for Mental Health (2020)
This briefing seeks to use evidence from existing research about the likely impact of the Covid-19 pandemic on the mental health of the UK population. It draws on published evidence to make projections about the potential impacts and which groups within the population face the highest risks to their mental health as a result of the crisis.
By The Mindfulness Initiative (2020)
A curated list of free mindfulness resources for health and care workers to support them through a time of crisis.